21D2128887 CLIA NUMBER - MARTIN'S PHARMACY #6104

Laboratory Demographics

CLIA Number: 21D2128887

Facility Name: MARTIN'S PHARMACY #6104

Facility Address:
1729 DUAL HIGHWAY
HAGERSTOWN, MD
ZIP 21740
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Facility Phone Number: 301 745-4904

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1962430942

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	21D2128887
LAB Type	Pharmacy
Facility Name	MARTIN'S PHARMACY #6104
Street	1729 DUAL HIGHWAY
City	HAGERSTOWN
State	MD
ZIP	21740
Phone	301 745-4904
CertificateType	4
CertificateEffectiveDate	4/10/2023
CertificateExpirationDate	4/9/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024